(1)
University of Florida, College of Medicine, Gainesville, FL, USA
(2)
Private Practice:, Orlando, FL, USA
11.1 Genetic Diseases
Disease | Inh | Gene mutation | Clinical Findings |
---|---|---|---|
Acrodermatitis Enteropathica | AR | SLC39A4 | Scaly eczematous plaques: perioral, perianal, hands, feet, scalp |
AEC Syndrome (Hay-Wells Syndrome) | AD | P63 (p63 protein) | Erosive scalp dermatitis, 80% cleft lip/palate, ankyloblepharon, hypotrichosis |
Albinism, Oculocutaneous Type 1 | AR | TYR (tyrosinase) | Severe nystagmus, ↑ SCC risk, pink nevi |
Albinism, Oculocutaneous Type 2 | AR | P (P protein) | Nystagmus, light brown hair, pigmented nevi |
Albinism, Oculocutaneous Type 3 | AR | TRP-1 (tyrosine-related protein) | Nystagmus, blue/brown iris, light brown hair/skin |
Albright Hereditary Osteodystrophy | AD | GNAS1 (encodes α subunit for stimulatory G protein of adenylate cyclase: Gs) | Pseudohypoparathyroidism, short stature, shortened 4th metacarpal, soft tissue calcification and ossification (i.e. osteoma cutis) |
Alkaptonuria | AR | HGD (homogentisate oxidase) | Dark urine on standing, ochronosis, valvular heart disease, arthritis, renal calculi, red-black ear wax |
Ataxia-Telangiectasia (Louis-Bar Syndrome) | AR | ATM (ataxia-telangiectasia mutated: chromosomal strand break repair) | ↑ Leukemia/lymphoma, ↑ sensitivity to ionizing radiation, ↑ sinopulmonary infections, progressive ataxia, telangiectasias |
Atrichia with Papules (Congenital Atrichia with Papules) | AR | HR (hairless gene: zinc finger) | Normal hair at birth but not replaced after hair sheds, follicular papules (± resembles keratosis pilaris) |
Bannayan-Riley-Ruvacalba Syndrome | AD | PTEN (tumor suppressor gene) | Macrocephaly, lipomas, hemangiomas, genital lentigines, trichilemmomas, ↑ breast/thyroid/GI CA |
Bazex Syndrome (Bazex-Dupre-Christol) | XLD | Unknown (gene linked to Xq24-q27) | Multiple BCCs, hypotrichosis, hypohidrosis, follicular atrophoderma (circumscribed areas on dorsal hands/feet) |
Beare-Stevenson Cutis Gyrata Syndrome | AD | FGFR2 (fibroblast growth factor receptor 2) | Cutis gyrata, acanthosis nigricans, craniosynostosis (premature fusion of certain bones in skull) |
Beckwith-Wiedemann Syndrome | AD (<15%) | CDKN1C (cyclin-dependent kinase inhibitor 1c, aka p57 or Kip2) | Macroglossia, circular depression (helices of ears), gigantism, midline abdominal wall defects, neonatal hypoglycemia, organomegaly, ↑ Wilms tumor |
Berardinelli-Seip Syndrome (Congenital Generalized Lipodystrophy) | AR | BSCL2 | Acanthosis nigricans, type 2 diabetes mellitus, generalized lipodystrophy |
Birt-Hogg-Dubé Syndrome | AD | FLCN (folliculin) | ↑ Fibrofolliculomas, trichodiscomas, lipomas, ↑ CA (renal/colon/medullary thyroid), lung cysts |
Björnstad Syndrome | AR, AD | BCS1L | Deafness, pili torti |
Bloom Syndrome | AR | BLM (RECQL3: DNA helicase) | Oral SCC, leukemia/lymphoma, GI CA, ↑ infections, poikiloderma, photosensitivity, hypogonadism |
Brooke-Spiegler Syndrome | AD | CYLD (cylindromatosis) | Multiple trichoepitheliomas, cylindromas, spiradenomas, ± BCCs |
Bruton Agammaglobulinemia | XLR | BTK (Bruton tyrosine kinase) | ↓ B cells with ↓ Ig levels, eczema resembling atopic dermatitis, recurrent bacterial infections like impetigo/furunculosis (especially encapsulated organisms) |
Buschke-Ollendorf Syndrome | AD | LEMD3 | Osteopoikilosis, connective tissue nevi (dermatofibrosis lenticularis disseminata) |
Carney Complex (LAMB, NAME) | AD | PRKAR1α (protein kinase c-AMP-dependent regulatory type 1 α) | Psammomatous schwannomas, thyroid disease, multiple lentigines, blue nevi, testicular tumors, cutaneous and cardiac myxomas |
Chédiak-Higashi Syndrome | AR | LYST1 (lysosomal transport) | Oculocutaneous albinism, ataxia, giant lysosomal granules, muscle weakness |
CHILD syndrome (Congenital Hemidysplasia with Ichthyosiform Erythroderma and Limb Defects) | XLD | NSDHL gene mutation | Unilateral ichthyosiform erythroderma, limb/visceral hypoplasia, stippled epiphyses |
Chondrodysplasia Punctata | XLR | Arylsulfatase E | Ichthyosis, sparse hair, stippled epiphyses (punctate chondral calcifications) |
Chondrodysplasia Punctata, Rhizomelic | AR | PEX7 (peroxisomal biogenesis disorder) | Stippled epiphyses, accumulation of phytanic acid, follicular atrophoderma, scarring alopecia, cataracts, rhizomelia (striking shortening of proximal limbs) |
Chondrodysplasia Punctate, XLD (Conradi-Hünermann-Happle Syndrome) | XLD | EBP (emopamil-binding protein) | Ichthyosiform erythroderma (along lines of Blaschko), follicular atrophoderma, patchy alopecia, cataracts, stippled epiphyses |
Chronic Granulomatous Disease | XLR (mostly) | CYBB (cytochrome B, b subunit → phagocyte NADPH oxidase defect, so unable to deliver respiratory burst for catalase-positive bacteria) | Recurrent infections, initially with staph infections around ears/nose, lymphadenopathy, cutaneous abscesses, suppurative lymphadenitis |
Citrullinemia | AD | ASS (arginosuccinate synthetase, in urea cycle) | Lethargy, poor feeding, seizures, vomiting |
Cockayne Syndrome | AR | ERCC8 (CSA) ERCC6 (CSB) | Premature aging, cataracts, cachectic dwarfism, retinitis pigmentosa, photosensitivity |
Congenital Contractural Arachnodactyly | AD | FBN2 (fibrillin-2) | Crumpled ears, arachnodactyly, long limbs, scoliosis |
Congenital Ichthyosiform Erythroderma (Nonbullous CIE) | AR | TGM1 (transglutaminase-1) ALOX12B (lipoxygenase) ALOXE3 (lipoxygenase) | Collodion membrane, generalized erythroderma with fine scaling (flexural involvement), palmoplantar keratoderma (PPK) |
Cowden Syndrome (Multiple Hamartoma Syndrome) | AD | PTEN (tumor suppressor gene) | Trichilemmomas, oral papillomas, ↑ CA (breast, thyroid follicular, colon), fibrocystic breast changes, cobblestoning of mucosa |
Cutis Laxa | AR | FBLN5 (fibulin 5) | Loose pendulous skin with decreased elasticity, diverticulae (bladder/GI), pulmonary emphysema, pulmonary artery stenosis |
Cutis Laxa | AD | ELN (elastin), FBLN5 | Loose pendulous skin, systemic involvement uncommon |
Cutis Laxa (Occipital Horn Syndrome, EDS IX) | XLR | ATP7A (copper transport disease) | Mild skin laxity, skeletal malformations, GU tract abnormalities, joint laxity |
Darier Disease (Darier-White Disease) (Keratosis Follicularis) | AD | SERCA2 (calcium-dependent ATPase 2A2) | Acrokeratosis verruciformis, warty papules/plaques in seborrheic distribution, red/white longitudinal streaking of nails with v-shaped nicks at free margin |
Dyskeratosis Congenita (Zinsser-Engman-Cole Syndrome) | XLR AD | DKC1 (dyskerin: ribosome assembly chaperone) TERC (telomerase RNA component) | Reticulate gray brown hyperpigmentation, dystrophic nails, alopecia, premalignant leukoplakia, pancytopenia, continuous lacrimation, ↑ malignancy |
EB Recessive Dystrophic (RDEB-HS) (Hallopeau-Siemens) | AR | Type VII collagen (premature termination codon) | Severe widespread bullae at birth, scarring on hands/feet (mitten deformity), nail dystrophy, mucosal strictures, ↑ oral/esophageal/skin SCCs |
EB, Dominant Dystrophic (DDEB) (Cockayne-Touraine) | AD | Type VII collagen (anchoring fibrils) | Bullae mainly over extremities, nail dystrophy, less severe than RDEB |
EB Simplex (Dowling-Meara) | AD | K5/14 (EM: clumped tonofilaments in basal layer) | Herpetiform bullae, early death, PPK, nail dystrophy, mucosal involvement (laryngeal, esophageal) |
EB Simplex (EBS) (Weber-Cockayne) (Localized) | AD | K5/14 (keratin) | Onset in childhood, bullae mainly in extremities (hands, feet), heals without scarring |
EBS with Muscular Dystrophy | AR | Plectin (hemidesmosome) | Muscular (myotonic) dystrophy, widespread bullae at birth, scarring, early death |
EB Junctional (JEB) (Herlitz) (EB Lethalis) Split at lamina lucida | AR | LAMA3 (subunit of laminin 5, now called laminin 332 ) (premature termination codon) | Widespread bullae, exuberant perioral granulation tissue, early death, enamel defects, severe mucosal involvement (respiratory/GI tract), ± hoarseness |
EB Junctional (Non-Herlitz) (Generalized Atrophic Benign EB) | AR | Laminin 332 (5) or BPAG2 | Bullae, mild oral involvement, scarring alopecia, improves over time |
EB Junctional with Pyloric Atresia | AR | α6β4 (integrin) | Bullae, pyloric atresia, hydronephrosis, mucosal erosions |
Ectodermal Dysplasia with Skin Fragility | AD | Plakophilin 1 and 2 (mainly) | Fragile bullae and erosions/crust, perioral fissuring and cheilitis, PPK, nail dystrophy |
EEC Syndrome (Ectrodactyly, Ectodermal Dysplasia, Cleft Lip/Palate) | AD | p63 gene | Cleft lip/palate, ectodermal dysplasia, ectrodactyly (absence of one or more central digits of hand or foot, also called ‘lobster claw deformity’) |
Epidermodysplasia Verruciformis | AR | EVER1, EVER2 | Abnormal susceptibility to human papillomaviruses of the skin (often HPV 5/8/47), ↑ SCCs |
Epidermolytic Hyperkeratosis (Generalized EHK) (Bullous CIE) | AD | K1, K10 (clumping of keratin filaments in suprabasal layers) | Erythema/blistering in infancy and replaced by hyperkeratosis (flexural predominance) |
Erythrokeratoderma Variabilis (Mendes da Costa) | AD (mainly) | GJB3 and GJB4 (connexin 31 and 30.3) | Transient erythematous figurate patches, fixed hyperkeratotic plaques |
Fabry Disease (Angiokeratoma Corporis Diffusum) | XLR | α-Galactosidase A | Angiokeratomas, pain/paresthesia of limbs, whorled corneal opacities, hypohidrosis, renal and coronary insufficiency, ‘maltese crosses’ (birefringent lipids in urine) |
Familail Mediterranean Fever (FMF) | AR | MEFV (pyrin, also known as marenostrin) | Recurrent febrile episodes with self-limited but painful episodes of synovitis, peritonitis, pleuritis |
Familial Partial Lipodystrophy (FPLD) | AD | LMNA (lamins A and C) | Absence of subcutaneous fat, muscular appearing arms/legs, acanthosis nigricans, diabetes mellitus |
Focal Dermal Hypoplasia (Goltz Syndrome) | XLD | POCRN (X chromosome: encodes acyltransferase) | Alopecia, fat herniation, osteopathia striata, mucocutaneous papillomas and pits |
Gardner Syndrome (Familial Polyposis of the Colon) | AD | APC (adenomatosis polyposis coli) | GI polyps, ↑ colon cancer, osteomas (jaw), supernumerary teeth, epidermoid cysts, CHRPE (congenital hypertrophy retinal pigment epithelium) |
Gaucher Disease | AR | β-Glucosidase (also known as glucocerebrosidase) | Erlenmeyer flask bone deformity, bone pain, aseptic necrosis, hepatosplenomegaly, ± CNS involvement |
Gorlin Syndrome (Nevoid BCC Syndrome) (Basal Cell Nevus Syndrome) | AD | PTCH (patched mutation → SMO activation [Hedgehog pathway] resulting in ↑ Gli) | Palmoplantar pits, jaw cysts, bifid ribs, ovarian fibromas, medulloblastomas, falx calcification |
Griscelli Syndrome | AR | Rab 27 A MyO5A (myosin V) | Pancytopenia, immunodeficiency, silvery gray hair, partial albinism, ↑ infections, neurological impairment |
Hailey-Hailey Disease (Familial Benign Chronic Pemphigus) | AD | ATP2C1 (golgi-associated Ca2+ ATPase, interferes with intracellular calcium signaling) | Flaccid blisters and erosions in intertriginous areas with vegetating plaques |
Haim-Munk Syndrome | AR | Cathepsin C | Erythematous PPK, onychogryphosis, periodontitis, early loss of teeth, acro-osteolysis |
Harlequin Fetus | AR | ABCA12 | Restrictive plate-like scales, eclabion, death due to respiratory difficulty and/or sepsis |
Hartnup Disease | AR | SLC6A19 (defective intestinal/renal neutral amino acid transport) | Pellagra-like dermatosis with photosensitivity, ataxia, tremors |
Hereditary Angioedema | AD | SERPING1 (gene for C1-INH, serine protease inhibitor) | Episodes of nonpitting swelling (angioedema), ± abdominal pain, diarrhea, paroxysmal colicky pain |
Hereditary Congenital Lymphedema (Nonne-Milroy) | AD | VEGFR3 (FLT4) | Congenital lymphedema, chylous ascites, bilateral pleural effusions |
Hereditary Hemorrhagic Telangiectasia (Osler-Weber- Rendu) | AD | ENG (endoglin) ACVRL1 (ALK1) | Pulmonary and hepatic AVMs, recurrent epistaxis, visceral hemorrhages (especially GI), telangiectasias |
Hermansky-Pudlak syndrome (HPS) | AR | HPS (lysosomal transport protein) | Oculocutaneous albinism, no dense bodies in platelets, ↑ bleeding, granulomatous colitis, pulmonary fibrosis |
Hidrotic Ectodermal Dysplasia (Clouston Syndrome) | AD | GJB6 (connexin 30: gap junction protein) | PPK, nail dystrophy, sparse hair, patchy alopecia, normal teeth, normal sweating, tufting of the terminal phalanges |
Holocarboxylase Synthetase Deficiency | HLCS (holocarboxylase synthetase) | Alopecia, perioral and perianal scaly dermatitis, lethargy, difficulty feeding | |
Homocystinuria | AR | CBS (cystathione β-synthetase) | Marfanoid habitus, downward displaced lens (ectopia lentis), thromboembolic events, neurologic features |
Howel-Evans Syndrome (Tylosis-Esophageal Carcinoma) | AD | TOC (envoplakin) | Focal PPK over pressure areas (balls of feet > hands), oral leukokeratosis, ↑ esophageal carcinoma |
Hunter Syndrome | XLR | Iduronate-2-sulfatase | Ivory-colored papules between scapula, cardiac involvment, joint stiffness, mental retardation |
Hurler Syndrome | AR | α-L-iduronidase | No skin findings |
Hyper-IgE Syndrome (Job Syndrome) | AD (mainly) | STAT3 | Recurrent ‘cold’ staph infections, eczema, retained primary teeth, ↑ eosinophils, ↑ IgE |
Hypohidrotic Ectodermal Dysplasia (HED) (Anhidrotic Ectodermal Dysplasia) (Christ-Siemens-Touraine) | XR | EDA (ectodysplasin A) EDAR (EDA receptor) NF-κB critical role | Hypotrichosis, ↓↓ sweating with heat intolerance, periorbital hyperpigmentation, peg-shaped teeth, anodontia, normal nails, saddle facies with large lips |
ADAR | |||
Hypohidrotic ED with Immunodeficiency (HED-ID)
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